Individual
DR. TIMOTHY O WALTNER
Active
Individual
DR. TIMOTHY O WALTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
2005010786
MO
2085R0202X
Diagnostic Radiology Physician
Primary
2005010786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114084522
—
MO
05
—
200270670B
—
KS
01
—
38347013
BCBSKC
MO
01
—
9499055
AETNA
MO
01
—
P00397045
RR MEDICARE
MO
Enumeration date
01/03/2007
Last updated
11/03/2014
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